Aspirin use, dose, and clinical outcomes in postmenopausal women with stable cardiovascular disease: the Women's Health Initiative Observational Study.
Aspirin use, dose, and clinical outcomes in postmenopausal women with stable cardiovascular disease: the Women's Health Initiative Observational Study.
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患有稳定心血管疾病的绝经后妇女的阿司匹林使用、剂量和临床结果：妇女健康倡议观察研究。
DOI：
10.1161/circoutcomes.108.791269
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Wassertheil-Smoller,Sylvia
中科院分区：
文献类型：
--
作者：
Berger,JeffreyS;Brown,DavidL;Burke,GregoryL;Oberman,Albert;Kostis,JohnB;Langer,RobertD;Wong,NathanD;Wassertheil-Smoller,Sylvia
背景-尽管有令人信服的证据表明阿司匹林在各种情况下可减少总体人群中的致命性和非致命性血管事件，但女性的代表性往往不足，其数据报告不足。我们试图评估阿司匹林的使用，剂量（81或325毫克），并与稳定的心血管疾病（CVD）绝经后妇女的临床结局之间的关系。方法和结果-妇女与CVD（n=8928）登记在妇女健康倡议观察性研究用于本分析。主要结局是全因死亡率和心血管事件（心肌梗死、卒中和心血管死亡）的发生率。在8928名CVD稳定的女性中，4101名（46%）报告服用阿司匹林，其中30%服用81 mg，70%服用325 mg。在6.5年的随访中，没有发现阿司匹林的使用与全因死亡率或心血管事件有显著相关性。然而，经过多变量调整后，与不使用阿司匹林相比，使用阿司匹林与显着降低的全因死亡率（调整后的风险比，0.86 [0.75至0.99];P=0.04）和心血管相关死亡率（调整后的风险比，0.75 [0.60至0.95];P=0.01）相关。阿司匹林的使用与心血管事件的风险较低相关（校正后的风险比为0.90 [0.78 - 1.04];P=0.14），但未达到统计学显著性。与325毫克相比，使用81毫克是没有显着差异的全因死亡率，心血管事件，或任何个人endpoint. Conclusions后，多变量调整，阿司匹林的使用与显着降低风险的全因死亡率，特别是心血管死亡率，绝经后妇女稳定的心血管疾病。81 mg和325 mg阿司匹林之间没有显著差异。总体而言，阿司匹林的使用是低的，在这个队列的妇女稳定的心血管疾病。
Background—Despite compelling evidence that aspirin reduces fatal and nonfatal vascular events among the overall population in various settings, women have frequently been underrepresented and their data underreported. We sought to evaluate the relationship between aspirin use, dose (81 or 325 mg), and clinical outcomes among postmenopausal women with stable cardiovascular disease (CVD).Methods and Results—Women with CVD (n=8928) enrolled in the Women’s Health Initiative Observational Study were used for this analysis. The primary outcome was the incidence of all-cause mortality and cardiovascular events (myocardial infarction, stroke, and cardiovascular death). Among 8928 women with stable CVD, 4101 (46%) reported taking aspirin, of whom 30% were on 81 mg and 70% were on 325 mg. At 6.5 years of follow-up, no significant association was noted for aspirin use and all-cause mortality or cardiovascular events. However, after multivariate adjustment, aspirin use was associated with a significantly lower all-cause (adjusted hazard ratio, 0.86 [0.75 to 0.99];P=0.04) and cardiovascular-related mortality (adjusted hazard ratio, 0.75 [0.60 to 0.95];P=0.01) compared with no aspirin. Aspirin use was associated with a lower risk of cardiovascular events (adjusted hazard ratio, 0.90 [0.78 to 1.04];P=0.14), which did not meet statistical significance. Compared with 325 mg, use of 81 mg was not significantly different for all-cause mortality, cardiovascular events, or any individual end point.Conclusions—After multivariate adjustment, aspirin use was associated with significantly lower risk of all-cause mortality, specifically, cardiovascular mortality, among postmenopausal women with stable CVD. No significant difference was noted between 81 mg and 325 mg of aspirin. Overall, aspirin use was low in this cohort of women with stable CVD.
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